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20 January 2010

Healthcare in the Suki Series

I may have touched on this before, but it was months ago and the topic is hot again in the news.
In the future (2030s) I imagined for the Suki series I had the couple as ahead of their peers in Libertarian thought and action, but I didn’t want to be preachy about it. Several times they are described as having some sort of medical care. In Suki I they both get checkups and pay with credit or money cards. They also happen to have the same general practitioner and discover that the day before an appointment.

In Suki II: Sunshine Returns, Suki’s therapist, also and MD, actually does house calls and she gets paid the same way too, cash.

The idea behind all of this was that they have doctors who do not deal with insurance companies or the government health system. ALL of their patients pay cash and their patients get to set unique terms that are not heard of or very rare now.

Suki’s deal with her therapist, Dr. DiMarco, is that Suki gets copies of all of her notes if she likes. She orders a complete copy of her file to give to John. Their individual deals with their GP, Dr. Donna, is similar. John has a copy of his complete medical file made for Suki.

I was not thinking that this would be the 2030s norm, but more common that what we have today. Plenty of people do similar things, but I don’t see it as customer driven, or at least it is not as customer driven as I would like. So I made the future more customer driven and a backlash against a period (between now and the 2030s) of imposed health insurance, doctors being forced to accept government and private insurance and all the rest that we are being threatened with today.

When I spoke to a therapist about the transaction structure for the future it seemed like it was so alien to him that I was a little worried it might be too far out there. Too bad, my future is my future. He was mentioned doctors today tiering their feed based on patient income. Nothing wrong with that, but I was thinking more of a self-tiering market, where better doctors charge more and patients see who they can afford based on the doctor’s pricing or other agreements. He also said that letting a patient have their notes was just not happening. Maybe now, but in a free market there may very well be therapists who do that.

Not mentioned in the books, but it was a thought for how the medical industry would be working, many small clinics for various specific procedures, like we have today for laser eye surgery and other things. I see this as only expanding, with more cosmetic surgery procedures available on an outpatient clinic basis.

In Suki III: Never Let Us End, John is hospitalized for a week. The couple subscribes to an ambulance service and that is what they take to the private hospital I invented (Admiral Grace Hopper Memorial) where they have a private room, smoking allowed. They pay for the whole ordeal cash (plastic).

A reader today may think that the couple is fabulously wealthy, but they are not. They are very successful, but they live in a freer-market world than we live in today. Technological advances and competition keep prices at their natural levels, not the inflated ones we have today due to overregulation. I note near the end of Suki I, through the dialogue between Patricia and Suki, that back when their mother’s were young a refrigerator cost more that the entire kitchen that Suki and John have at the condo. This is due to global competition on durable goods, and most everything else.